Fellowshipping: Month 5

The fifth month of my fellowship came and went by pretty quickly, and I spent it at the outpatient spine clinic and the neurosurgery inpatient floor. 

The spine clinic was a different ball game to me. Sure, I've taken care of some spine patients while they were inpatient, but learning the initial consultation and seeing them post-operatively in the outpatient setting was a new learning curve. Oh, and add in that chief complaint of pain. 

I went through the whole transition of learning who's who at the spine clinic site, learning the outpatient workflow of this clinic, and working with a population with a neuro spine focus. I also learned to work with the two spine attendings who are similar in the type of conditions they treat, yet different in their preferences for things (ie. when to order imaging, etc). 

While I've learned how to adjust for the most part to the flow of the clinic, I've also learned to keep pushing myself and work towards better time management and seeing more patients while at this clinic. Looking back now one month into my time at the spine clinic, I can say I've learned and improved a lot as a provider in just this short time thus far.

I am forever grateful to my physician assistant co-worker who helped me build my foundation in neurospine. I spent my first two weeks sitting, watching, and learning in clinic with her. It was just about the time that the first wave of COVID was ending, and patients were starting to come in again. She took me under her wing providing me with things to read, explaining her way of reading imaging, and letting me be a part of the behind-the-scenes work that goes into determining if a referral is appropriate or that further information is needed. 

Conditions/terms I've learned about this month:

• Multilevel spondylosis
• Adjacent level disease
• Facet arthropathy
• Levoscoliosis
• Disc dessication
• Disc osteophyte complex
• Orthofix
• Plantar flexor response
• Myelopathies (cervical and lumbar)
• Significance of Hoffman-Tromners sign
• Tarlov cyst
• Lumbar post-laminectomy syndrome
• Provocative discogram and control

I'm curious to see how much more I will grow in this next month of fellowship continuing in the neurospine side of neurosurgery. 

Nicole G.

@nextwithnicole // @nursenicoleg